Individual provider Active NPI

Angela P Russell

  • Nurse Practitioner
  • Miami, FL
National Provider Identifier
1902826993
Registry record updated Sep 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
ARNP1082342 Issued in FL
Practice address
1475 NW 12TH Ave
Box 016960 M851
Miami, FL 33136-1002
Phone
(305) 243-7520
NPI assigned
Jul 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X ARNP1082342 FL Primary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 1082342 FL
Family Health Clinical Nurse Specialist 364SF0001X 082342 FL

Addresses

Primary practice location

1475 NW 12TH Ave
Box 016960 M851
Miami, FL 33136-1002

Mailing address

1475 NW 12TH Ave
Box 016960 M851
Miami, FL 33136-1002
Phone (305) 243-7520

Other identifiers 1

IdentifierTypeStateIssuer
3050742-00MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100928000622 FL Practitioner - Nurse Practitioner 4688790603 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
87.93 of 100Reported as group
Quality
78.79
Promoting interoperability
100
Improvement activities
40
Cost
71.44

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1082342FLMDPsychiatric/Mental Health Nurse Practitioner
082342FLMDFamily Health Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
University of Miami Nurse Practitioner CurrentSince Jan 1, 2020 Accepting new patients
University of Miami Current Accepting new patients

Locations

4800 NE 20th Ter
Ste 201
Ft Lauderdale, FL 33308
Phone (305) 892-4000

1475 NW 12th Ave
Miami, FL 33136
Phone (305) 243-4200

1475 NW 12th Ave
#16960
Miami, FL 33136
Phone (305) 243-6802

1611 NW 12th Ave
Miami, FL 33136
Phone (305) 585-6226

1150 NW 14th St
Ste 609
Miami, FL 33136
Phone (305) 243-7400

Interoperability endpoints

  • Direct secure messaging: arussell7300@direct.med.miami.edu

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410998400000",
    "number": "1902826993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1475 NW 12TH AVE",
            "address_2": "BOX 016960 M851",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331361002",
            "telephone_number": "305-243-7520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1475 NW 12TH AVE",
            "address_2": "BOX 016960 M851",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331361002",
            "telephone_number": "305-243-7520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "ANGELA",
        "middle_name": "P",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-20",
        "last_updated": "2014-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP1082342",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "1082342",
            "primary": false
        },
        {
            "code": "364SF0001X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Family Health",
            "state": "FL",
            "license": "082342",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3050742-00",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.